Visual and refractive outcomes with intrascleral haptic fixation of the light adjustable lens.

Abstract

Purpose: To describe refractive outcomes with intrascleral haptic fixation (ISHF) of the light adjustable lens (LAL).

Setting: Baylor College of Medicine and 1 private practice in the United States.

Design: Retrospective sequential cohort.

Methods: All patients undergoing double-needle ISHF of the LAL were included in the study. Pretreatment and post-lock-in uncorrected distance visual acuity (UDVA) were recorded. Mean numerical errors, refractive prediction errors, and astigmatism outcomes were measured.

Results: 10 eyes were included. Initial pretreatment UDVA after surgery ranged from 20/25 to 20/150, and post-lock-in UDVA ranged from 20/12.5 to 20/40 (median UDVA 20/20; mean 0.01 logMAR [spherical equivalent 0.04]). Mean magnitude of refractive astigmatism was 0.70 diopters (D) (range 0.00 to 1.50 D) pretreatment and 0.25 D (range 0.0 to 0.75 D) after final lock-in. Pretreatment mean numerical error was +1.00 D (SD 0.94 D) and was reduced to -0.022 D (SD 0.28) after treatments and lock-in sessions. All eyes (10/10) achieved their full visual potential in UDVA.

Conclusions: This study illustrates that with careful planning and patience, patients with poor or absent capsular support who previously did not have a customizable option can potentially achieve personalized visual outcomes with excellent refractive accuracy with scleral fixation of the LAL.